HomeMy WebLinkAbout2002-P05616 - detached garage CITY OF R N PERMIT
� � � Permit Number:
2750 Kelley�Parkway- PO Box 66 P05616
Crysta�l E3ay, Minnesota 55323 Permit Type: Addition/RemodeURepair
(952) 249-4600 Date Issued: loiiii2oo2
SITE ADDRESS: 4064 North Shore Dr
Mound,MN 55364
PID: o�-i i�-23-aa-oogs
DESCRIPTION: UBc occupancy R3
Proposed Use: Residential
Permit Class: Building Census Code 438
Permit Type: Addition/RemodeURepair P�t Sub-type(s): Gazage-Detached
DErAILS:
Approved per resolution#:
Separate permits required: Biecmc�i(siaie�
NOTICES/REMARKS:
FEE SUMMARY: Permit Fee: $ 97.25 Valuation: $ 4,000.00
Plan Review Fee: $ 63.18
State Surcharge Fee: $ 2.50
TOTAL FEE: $ 162.93
APPLICANT: D�P�pps OWNER' Dan Phipps
4064 North Shore Dr � �
Mound,MN 55364
Tf�UNDERSIGNID HIItEBY REQUESTS PERMISSION TO MAKE THE REAL IMPROVEMENTS SPECIFIED
AND AGREES TO DO ALL WORK IN STRICT COMPLIANCE WITH ALL CITY OF ORONO ORDINANCES AND STATE OF
MINNESOTA BUII,DING CODE REQUIREIVIII�ITS.
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C.it
APPLICANT PE E SIGNATURE IS D BY SIGNA
Covies: 1-File(SiAnitures Requi�ed),1-Aunlicant,l-Monthlv Revorts, 1-A�essin¢,1-Finance Page 1
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� Total Fee: $ ' ' � - ' J Date Received: —/� �-'��
Entered By: ,�1/'1 � Permit#: �'%�S (���k�
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CITY OF ORONO - B'(�ILDING PERMIT APPLICATION
All information must be submitted in full before plan review will be started.
(please print all information)
----------------------------------------------------- ------ -----------------------------------------------------
THE APPLICANT IS: (circle one OWNE OR CONTRACTOR
JOB SITE ADDRESS: �U�o� ,UO k'T H S 1�c�/�L= L7� ZIP: 5� �Co�{
NAME OF OWNER: � � � ' S PHONE: (home) -�1 SZ-�7 Z ���
(work) Q �Z- g'��-/ -9Y y�,-
MAILING ADDRESS: �JOC�y l;a��►,{ Sf�v�� p� CITY: c��c�� ZIP: 5�53�y'' �'
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CONTRACTOR: S �+w��C PHONE. v . ` \
CONTACT PERSON: MOBILE/PAGER: � O
MAILING ADDRESS: CITY: ZIP: ��
STATE LICENSE: # ����
ARCHITECT/ENGINEER: �-�-�-,.�� PHONE:
MAILING ADDRESS: CITY: ZIP:
NAME: REGISTRATION#
TYPE OF WORK: New Addition� Accessory Structure X
Move Remodel/Alteration� Land Alteration
PROPOSED WORK(describe in detai�: S�A(',, c, � q 2 r1 � € ��d +a�v
-�v �x �s�� n c C �9�c S ) c; .�2.��, �:.
STORIES: l SQ. FEET OF EACH FLOOR: S � 1
NO. OF BEDROOMS: GARAGE STALLS: ATT. DET.
ESTIMATED CONSTRUCTION VALUATION (excluding land): $ �/CUOC� ��
I hereby apply for a building permit and I acknowledge that the information above is complete and
accurate; that the work will be in conformance with the ordinances and codes of the City and with
the State Building Code; that I understand this is not a permit and work is not to start without a
permit; and that the work will be in accorda ce 'th the approved plan.
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APPLICANT'S SIGNATURE: � �'� DATE: c� -- I S -� Z
NOTE! Parade o Homes events require separate permit approval by Police Department and
City Council 60 days prior to the event. Non permitted events will not be allowed.
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Sec.13.04 RIGATS OF SZJBJECTS OF DATA >
.
Subd. 1. Type of data. The rights of individual on whom the data is stored or to be stored shall be as set forth in this section.
Subd.2. �nformatton required to be�tven individual. An individual asked to supply private or confidential data concerning himself
shall be informed of: (a)die purpose and intended use of the requested data widrin the collectiag state agency,political subdivision,or statewide
system;(b)whether he may refuse or is legally required to supply the requested data;(c)any lmown consequence arising from his supplying or
refusing ro supply private or wnfide�ial data;and(d)the identity of other petsons or entities authorized by staoe or federal law to receive the data.
This requirement shall not apply when an individual is asked to supply investigative data,pursuant to secdon 13.82, subdivision 5,w a law
enforcement officer.
The commissioner of revemie mav nlace the norice reauired under this subdivision in the individual income tax or nronertv tax refund
instrucdons instead of on those forms.
Subd.3. Acccss to data by individual. Upon request to a responsible authority,an individual shall be informed whether he is the
subject of stored data on individuals,and whether it is classified as public,private or confidential. Upon his fuither request,an individual who
is the subject of stored private or public data on individuals shall be shown ihe data withwt any charge w him and,if he desires,shall be informed
of die content and meaning of that data. After an individual has been shown the private data and informed of its meaning,the data need not be
disclosed to him for six monthc diereafter unless a dispute or actiott pursuant to this section is pei�ing or addidonal data on the individual has been
collected or created. The respoasible audioriry sha(1 provide copies of the private or public data upon request by the individual subject of the data.
The responsible au�ority may require the requesdng person to pay the actual costs of maldng,certifying,and compiling the copies.
The responsible authoriry.shall comply immediately,if possible,widi any request made pursuant to this subdivision,or within five days
of the date of the request,excluding Saturdays,Sundays and legal holidays,if immediate compliance is not possible. If he cannot comply with
the request within that time,he shall so inform the individual,and may have an additional five days within wlrich to comply with the request,
excluding Saturdays,Sundays and legal holidays.
Subd.4. Procedure when data is not accurate or complete. An individual may contest the accuracy or completeness of public or
private data coaceming himself. To exercise this right,an individual shall notify in writing the responsible authority describing iha�nature of the
disagreemem. The responsble authoriry shall within 30 days either: (a)comct the data found to be inaccuiate or inco�lete and attempt to notify
past recipiems of inaccurate or iacomplete data,including recipientc named by the individual;or(b)nodfy the individual that he believes the data
to be correct. Data in dispute shall be disciosed only if the individual's statement of disagreement is included with tt►e disclosed data.
The determinaaon of the responsible authority may be appealed pursuant to the provisions of the administrative procedure act relating
to contested cases.
DATA PRIVACY ADVISORY
In accordance with M.S. 13.04, Subd. 2, "Rights of subjects of data", we would like to inform you that your
request for a permit or license from the�ity of Orono or any of its departments may require you to furnish certain
private or confidenrial information.
You aze notified that:
1. The informarion you furnish will be used to determine your qualification for the permit or license
requested.
2. You may refuse to supply data,but refusal may require that the City deny the permit or license.
3. The information may be shared with other local, state or federal agencies to the extent necessary to
process the permit or license.
4. If your requested permit or license requires CouncIl action to approve, some information may become
public.
5. You have certain rights under M.S. 13.04(available upan request)to review private data on yourself.
6. Your full name is required to process this application or permit.
First Middle Last
Address
City State Zip Phone
I understand my rights as stat ove.
Signature
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� ' CHECB OFF LIST FOR ISSUANCE OF PERMITS
� FOR OFFICE USE ONLY
� ADDRESS OR LEGAL: yO�Y NDR�SH�f� d`t -
PID:
DESCRIPTION OF WORK: GA tzA�� r4D&>>'T't o N
ZONING REVIEW BY: DATE APPROVED: lc -�j-a 2.
BUILDING REVIEW BY: DATE APPROVED: � o •5-o Z,
FEES TO BE CHARGED: Misc. Fees Calculated By:
PERNIIT Yes _�' No
PL�N REVIEW Yes � No SEWER CONNECTION
STATE SURCHARGE Yes _� No WATER CONNECTION
INVESTIGATION FEE Yes No PARK FEE
SAC Yes No ' SITEINSPECTION
Number of SAC Units OTHER (specify)
ZONING CHECK LIST Zoning District:
Fire Department: Post Office: School District:
Lot Area: Sq.ft. Acres Width Depth
Survey Submitted: Yes� No Date of Survey: pN t��.`.
Proposed Setbacks:
Front(Lake): gg' � Right Side: 6Z.` '�
" Rear(Street): 13' � Left Side: � �' �
Adjacent Structures: ZZ� Wetland: N/A
Building Height: Def. Hgt. p.� Peak Hgt. 0.)�.
Lot Coverage: S.�
Grading: Staff Approval Date: --' By: Council Approval Date:
Septic: Staff Approval Date: — By:
Zoning File: # — Resolution: # Resolution Date:
Shoreland District: s
Avg. Setback. �,� /� Bluff Setback: N//F- Lot Coverage:
Existing Proposed
Hazdcover: 0-75'
75-250'
250-5�' o•��
500-1000'
Hazdcover Variance Required: Yes No� Date of Council Approval:
REMARI�S(in house):
7
BUII..DING REVIEW CHECK LIST ' � �
UBC: R• 3 CONSTRUCTIO�T TYPE: V N
Sq Footage $Per Sq Ftg
Basement.� x =
lst Floor x =
2nd Floor x =
Gazage x =
R =
TOTAL
Estimated Construction Value: $ �t,0 CO O°
Inspections Required: Work Requiring Separate Permits:
Site Plumbing Fire
Hazdcover Removal Mechanical Water Connection
oC Footing Septic Sewer Connection
_�Framing Fireplace Lawn Irrigation
Insulation (Masonry) Other
Wall Board (Mfg.) Well(State Permit)
_�c Final Grading/Filling �Electrical(State Permit)
Other
REMARI�S(IN HOUSE): .
REVIEW BY OTHERS: DATE:
Access: Existing New
Access Approval: Date By:
REMARKS (TO BE NOTED ON PERMIZ�:
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INSPECTION NOTICE SCHEDULED � / " f��
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ADDRESS "` S �2.
OWNER � �� S CONTR.
TELEPHONE NO. ��Z � �{�7 Z - � -7 b9
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� DESCRIPTION /�C�f�LL��" '-- Y�C��
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Q 02 fRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
y 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
Z04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
Q 05 FINAL 14 SEWER HOOK-UP 06 PROGRESS
� 07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT
v 07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
= 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
J 10 PIUMBING FINAL ; 36 FOUNDATION/REMOVAL
� OWNERICONTRACTOR TO MEEf YOU:�YES_NO
� COMMENTS:
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V BEFORECOVERING PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. � pHOTOTAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CAIL INSPECTOR
❑CITATION ISSUED
O INSPECTION REQUIRED.CALLTO ARRANGE ACCESS.
Call for the n t inspection 24 hours in advance. (952� 249-4600
OwnerlCon r site:
Inspector. � -
White Copy/lnspector's F e Canary Copy/Site Notice
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T DATE TIME
CITY OF ORONO CALLED IN
INSPECTION NO E SCHEDULED �� G'2 � : �
PERMIT N0. r 1r � COMPLETED
ADDRESS �F C�� �1'�� 1�l {`3'-�/i� S�I .D�?
OWNER �l�l���nS CONTR. >C�.�°Y1Y_
TELEPHONE NO. � �
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� DESCRIPTION �r)(�Z[�(�
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� 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
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Z 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
Q OS FINAL 14 SEWER HOOK-UP O6 PFiOGRESS
� 07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT
� 07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
= 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
� 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL
� OWNERICONTRACTOR TO MEET YOU�YES_NO
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� BEFORE COVERING
PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. p pHOTOTAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED
O INSPECTION REQUIRED.CALLTO ARRANGE ACCESS.
Call for the next in pection 24 hours in advance. (952) 249-4600
OwnerlContractor
Inspector.
White Copy/lnspector's File Canary CopylSite NoNce
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1 D/rZ'E� TIME
CITY OF ORONO CAL�D IN `�� �
INSPECTION N IC SCHEDULED 1=� �.�-
PERMIT NO. COMPLETED
ADDRESS �O�p� /�. cSGLd`+d �
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TELEPHONE NO.__ !s�' �7�- S ZD�
� DESCRIPTION ��'�'P � � -'
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� 02 FRAMINt3 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
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03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE HEMOVAL
Z 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
Q 05 FlNAL 14 SEWER HOOK-UP 06 PROGRESS
� 07 DEMO—SfTE 27 SEPTIC MAINT. 21 COMPLAINT
Q 07 DEMO—FINAL 15 SEPTIC INSTALL 22 FOLLOW-UP
= 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
J 10 PLUMBING FlNAL 36 FOUNDATIOWREMOVAL
� OWNERICONTRACTOR TO MEET YOU:_YES_NO
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INSPECTOR WILL HEfItRN ❑CITATION ISSUED
❑STOP ORDER POSTED.CALL INSPECTOR
�INSPECTION REQUIRED.CALLTO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. (g52) 249-46�0
Owner/Contractor s'
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White Copyllnspector's Flle Canary Copy/Site NoUce
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